The Causes Behind Spinal Compression Fracture
By Neurosurgery Singapore
What is Spinal Compression Fracture?
A spinal compression fracture due to osteoporosis (weak bones) is commonly referred to as a compression fracture, but can also be called a vertebral fracture, osteoporotic fracture, or wedge fracture.
A compression fracture is usually defined as a vertebral bone in the spine that has decreased at least 15 to 20% in height due to fracture.
While wedge fractures are the most common type of compression fracture, there are other types as well, such as:
- Crush fracture. If the entire bone breaks, rather than just the front of the vertebra, it may be called a crush fracture.
- Burst fracture. This type of fracture involves some loss of the height in both the front and back walls of the vertebral body (rather than just the front of the vertebra). Making this distinction is important because burst fractures can be unstable and result in progressive deformity or neurologic compromise.
What are some symptoms of Spinal Compression Fracture?
Along with back pain, spinal compression fractures also can cause:
- Pain that gets worse when you stand or walk but with some relief when you lie down
- Trouble bending or twisting your body
- Loss of height
- A curved, stooped shape to your spine
The pain typically happens with a slight back strain during an everyday activity like:
- Lifting a bag of groceries
- Bending to the floor to pick something up
- Slipping on a rug or making a misstep
- Lifting a suitcase out of the trunk of a car
- Lifting the corner of a mattress when changing bed linens
“Fractures caused by osteoporosis most often occur in the spine. Spinal fractures — called vertebral compression fractures — occur an estimated 1.5 million times each year in the United States. “
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What types of diagnosis?
To diagnose compression fracture, our Specialist will take a complete medical history and perform a physical examination. If a compression fracture is suspected, our doctor may order the following diagnostic procedures:
- X-ray (also known as plain films) –test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse, or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
- Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- Computed tomography scan (CT scan): a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
- Nuclear bone scan: a diagnostic procedure in which a radioactive substance is injected into the body to measure activity in the bones. (The amount of radiation is small–less than the radiation in half of one CT scan.) This scan helps identify damaged bones.
Since compression fractures usually occur in weakened bone, our doctor may order additional tests to look for osteoporosis, tumor, or infection.
Possible treatment methods?
Treatment for a compression fracture depends on the nature of the break and the likely cause. Our Specialist non-surgical approaches include:
Taking pain medications
Resting in bed until better
Wearing a back brace
Going to physical therapy
Treating osteoporosis if bone weakening is suspected
If the body does not respond well enough to recovery, the surgical options include:
Fusion: Repairing the bone and joining vertebrae together after an injury
Tumor treatment: Removing bone (if needed) to treat a tumor
Kyphoplasty: Making the vertebrae taller with a small balloon placed with a needle, then filling the empty space with a special cement. This procedure can help with pain from a vertebral fracture that persists more than 6 weeks, but it does have risks. Potential risks of this procedure should be discussed with our doctor.